Neurofeedback and Cognitive Training for PBTS

NCT ID: NCT07085494

Last Updated: 2026-01-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ENROLLING_BY_INVITATION

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-01

Study Completion Date

2028-08-31

Brief Summary

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Brief Summary of the Study:

This study is a prospective, randomized, sham-controlled, triple-blind trial investigating whether combining individualized alpha neurofeedback (NF) with cognitive training (Cogmed) can improve cognitive functioning in pediatric brain tumor survivors (PBTS), a group at risk for persistent cognitive difficulties after cancer treatment. Participants (ages 6-18) who have completed primary cancer therapy and report cognitive problems are randomly assigned to either (1) individualized alpha NF plus Cogmed or (2) sham NF plus Cogmed. Both interventions include eight one-hour sessions over four weeks, with neurofeedback (real or sham) followed by Cogmed training.

The primary outcome is cognitive performance measured by CNS Vital Signs at baseline, post-intervention, and 12-month follow-up. Secondary outcomes include attention, executive function, behavior, and quality of life (measured by SWAN, BRIEF, SDQ, and PedsQL). The study uses rigorous double-blinding and intention-to-treat analysis, with sample size planned at 40-60 participants. Results will determine if individualized alpha NF, when combined with cognitive training, yields greater cognitive and behavioral benefits than cognitive training alone in PBTS.

Detailed Description

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This study is a prospective, randomized, sham-controlled, double-blind trial designed to evaluate whether individualized alpha neurofeedback (NF) combined with cognitive training (Cogmed) can improve cognitive functioning in pediatric brain tumor survivors (PBTS), who frequently suffer from attention, memory, and executive function difficulties following cancer treatment.

Participants:

The study plans to enroll 40-60 PBTS, aged 6 to 18, who have completed primary cancer treatment at least six months prior and report cognitive difficulties. Major exclusion criteria include severe neurological or psychiatric conditions, interfering medications, and significant sensory or motor deficits.

Design and Intervention:

Participants are randomly assigned (1:1) to one of two groups:

1. Individualized Alpha Neurofeedback + Cogmed (NF Group)
2. Sham Neurofeedback + Cogmed (Sham Group) Both groups participate in eight one-hour sessions over four weeks. Each session includes 30 minutes of neurofeedback (either real, based on each participant's individualized alpha EEG band, or sham, based on pre-recorded EEG data but with identical procedures) followed by 30 minutes of Cogmed cognitive training (adaptive, computerized working memory tasks).

Blinding:

The study is double-blind: both participants and outcome assessors are blinded to group allocation. The neurofeedback software automatically delivers either real or sham feedback according to assignment, maintaining blinding for all involved.

Objectives and Outcome Measures:

The primary objective is to determine whether the combined individualized alpha NF and Cogmed intervention leads to superior improvements in cognitive functioning, measured by CNS Vital Signs, compared to sham NF plus Cogmed. Assessments occur at baseline, immediately post-intervention, and at 12-month follow-up.

Secondary objectives include evaluating changes in attention, executive function, behavior, and quality of life, using validated tools such as the SWAN, BRIEF, SDQ, and PedsQL. The study will also examine neurophysiological changes (qEEG markers) and their relationship to cognitive and behavioral outcomes.

Data Analysis:

Primary and secondary outcomes will be analyzed using mixed linear models to assess group-by-time interactions. An intention-to-treat approach will include all randomized participants, with appropriate methods for handling missing data.

Significance:

This study will clarify whether adding individualized alpha neurofeedback to cognitive training offers additional cognitive and behavioral benefits for pediatric brain tumor survivors, compared to cognitive training alone, using a rigorous double-blind, sham-controlled methodology with a planned sample size of 40-60 participants.

Conditions

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Brain Tumor, Primary

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Once eligible participants are enrolled in this study, they will be randomly allocated either to the neurofeedback intervention group or the sham feedback group. Participants in both groups will receive treatment/sham neurofeedback treatment at the same period. Partcipants in both groups receive cognitive training
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
A deterministic blinding method will be used. Each participant receives a unique de-identified ID (for example, "NFB001"), which will be processed with a custom hashing function that produces a binary value (0 or 1) with equal probability. This determines whether they receive individualized alpha feedback or sham feedback (by customised algorithm). Throughout the study, only the participant's de-identified ID is visible to researchers, site staff, and participants, thus preserving blinding.

Study Groups

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Neurofeedback + Cognitive trianing

Participants will receive neurofeedback and cognitive training

Group Type EXPERIMENTAL

neurofeedback

Intervention Type BEHAVIORAL

\- Neurofeedback Training : Feedback is based on individualized alpha band power. Participants see a game-like display (for instance, a plane) that reflects their alpha activity. Excessive EMG (muscle tension) causes performance drops, encouraging relaxation.

Cognitive Training

Intervention Type BEHAVIORAL

\- Cogmed Training : Participants complete adaptive tasks focusing on working memory. The difficulty adjusts in real time based on performance.

Sham neruofeedback + cognitve trianing

Participants will receive sham neruofeedback and cognitive training

Group Type SHAM_COMPARATOR

Cognitive Training

Intervention Type BEHAVIORAL

\- Cogmed Training : Participants complete adaptive tasks focusing on working memory. The difficulty adjusts in real time based on performance.

Sham feedback

Intervention Type BEHAVIORAL

The sham neurofeedback protocol was identical to the verum neurofeedback protocol except that the animation (horizontal plane movement) was based on the EEG results of another participant. EMG-based feedback will still be provided for the sham condition

Interventions

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neurofeedback

\- Neurofeedback Training : Feedback is based on individualized alpha band power. Participants see a game-like display (for instance, a plane) that reflects their alpha activity. Excessive EMG (muscle tension) causes performance drops, encouraging relaxation.

Intervention Type BEHAVIORAL

Cognitive Training

\- Cogmed Training : Participants complete adaptive tasks focusing on working memory. The difficulty adjusts in real time based on performance.

Intervention Type BEHAVIORAL

Sham feedback

The sham neurofeedback protocol was identical to the verum neurofeedback protocol except that the animation (horizontal plane movement) was based on the EEG results of another participant. EMG-based feedback will still be provided for the sham condition

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* \- Paediatric brain tumour survivors aged 6 to 18 years
* Completion of primary cancer treatment (for example, surgery, chemotherapy, or radiotherapy) at least six months prior
* Documented or reported cognitive difficulties in attention or executive functioning
* Ability and willingness to attend scheduled sessions over four weeks

Exclusion Criteria

* \- Severe neurological or psychiatric conditions (for example, uncontrolled seizures) that preclude EEG monitoring or completing computer-based training
* Medication regimens that significantly interfere with EEG signals and cannot be safely adjusted
* Severe sensory or motor deficits that would make training infeasible
* Inability or unwillingness to follow study protocol
Minimum Eligible Age

6 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The University of Hong Kong

OTHER

Sponsor Role lead

Responsible Party

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Winnie Wan Yee Tso (Dr)

Clinical Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Hong Kong Children's Hospital

Hong Kong, , Hong Kong

Site Status

Countries

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Hong Kong

Other Identifiers

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HKU_PBTS_NF_CT

Identifier Type: -

Identifier Source: org_study_id

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